Nascer no Brasil: a presença do acompanhante favorece a aplicação das boas práticas na atenção ao parto na região Sul

Abstract

OBJECTIVETo analyze if the presence of a companion favors the use of best practices in the delivery care in the South region of Brazil.METHODSThis is a cross-sectional analysis of the longitudinal study Nascer no Brasil. We analyzed data from 2,070 women from the South region of Brazil who went into labor. The data were collected between February and August 2011, by interviews and medical records. We performed a bivariate and multivariate analysis, calculating the crude and adjusted prevalence ratios using Poisson regression with robust variance estimation. The level of significance adopted was 5%.RESULTSMost women had a companion during labor (51.7%), but few remained during delivery (39.4%) or cesarean section (34.8%). Less than half of the women had access to several recommended practices, while non-recommended practices continue to be performed. In the model adjusted for age, education level, source of payment for the delivery, parity, and score of the Brazilian Association of Market Research Institutes, the presence of a companion was statistically associated with a greater supply of liquids and food (aPR = 1.34), dietary prescription (aPR = 1.34), use of non-pharmacological methods for pain relief (aPR = 1.37), amniotomy (aPR = 1.10), epidural or spinal analgesia (aPR = 1.84), adoption of non-lithotomy position in the delivery (aPR = 1.77), stay in the same room during labor, delivery, and postpartum (aPR = 1.62), skin-to-skin contact in the delivery (aPR = 1.81) and cesarean section (PR = 2.43), as well as reduced use of the Kristeller maneuver (aPR = 0.67), trichotomy (aPR = 0.59), and enema (aPR = 0.49).CONCLUSIONSIn the South region of Brazil, most women do not have access to the best practices in addition to undergoing several unnecessary interventions. The presence of a companion is associated with several beneficial practices and the reduction in some interventions, although other interventions are not impacted.

Obstetric Nursing in best practices of labor and delivery care

“…It is important to emphasize the importance of the companion in the delivery and birth process, a study carried out in southern Brazil, showing that the support of the companion is associated with best practices and movement, able to reduce the pain and duration of LA (31) .…”

“…The presence of Obstetric Nursing in the institution was associated with non-performance of trichotomy when compared to institutions that did not have Obstetric Nursing. In 2014, a systematic review demonstrated that there is insufficient evidence to recommend perineal tricotomy for women on admission to LA (34) , since it does not influence better rates of infection, dehiscence of the perineal wound or other neonatal infections (31) .…”

Percepção do acompanhante quanto ao seu acolhimento durante o parto

“…13 The role of mediator is exercised when the companion is welcomed and encouraged to develop comfort actions, negotiating the parturient's wishes with the health team, as well as actively participating in the application of non-pharmacological methods of pain relief. 21 It is revealed in the third sub-category, "Respect for the rights of the accompanying person", that the participants stress the importance of their participation and of having their law respected by the institution and professionals:…”

“…25 It is exposed that the health institutions in Brazil that allow the presence of the companion are those that seek to reduce unnecessary interventions, and that have programmed changes in the ambience and in the furniture, such as having chairs for all the companions. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] The organization of physical spaces is necessarily altered when a mode of attention to childbirth and birth is sought which privileges the privacy, dignity and autonomy of the woman when giving birth in a more welcoming and comfortable environment with the presence of companion. 24 The conditions of the environment for the humanization of births and births must comply with all these guidelines, as recommended in Resolution No.…”

A Musicoterapia e a Música na Medicina como terapia adjuvante no âmbito da Obstetrícia: Uma Revisão Bibliográfica

“…Sua prevalência ainda é alta, chegando 15% no trabalho realizado por (MONGUILHOTT et al, 2018), que visava avaliar estatisticamente, como nascem os brasileiros em nosso serviço público. Nele, foi no inferido que apenas 34,8% das mães tiveram a presença de um acompanhante durante o parto, o que também é fator de sofrimento para a mãe.…”